Application of Ultrasonic Imaging for Assessment of Pelvic Floor Muscle Function

Document Type : Original article

Authors

1 Assistant Professor of Physiotherapy, Dept. of Physiotherapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran (corresponding author)

2 Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran-Iran.

Abstract

Background and Aim: In the past two decades, numerous studies using ultrasonographic imaging and indicators such as the bladder or urethra mobility were conducted to assess the pelvic floor structure and morphology, also to diagnose disorders like urinary in continence as well as prolapsed and their severities. Regarding the Rehabilitative Ultrasound Imaging (RUSI) and the importance of studying pelvic floor muscle function for physiotherapists, this article aimed to review practical aspects of two common ultrasonographic imaging methods for assessment of pelvic floor muscles’ function.
 
Conclusion: Trans-abdominal and Trans-labial have been introduced as two common ultrasonographic methods to evaluate pelvic floor muscle function. However, Trans-labial method is more sensitive with less measurement error. No need to get dressed, quick imaging and viewing the patient's bladder are considered as advantages of Trans-abodominal approach.

Keywords


  1. Dietz HP. Ultrasound imaging of the pelvic floor. Part I: two-dimensional aspects Ultrasound Obstet Gynecol. 2004; 23(1):80-92
  2. Dietz HP, Hoyte LPJ. Steensma AB Atlas of pelvic floor ultrasound. London: Springer; 2008. P. 23-29
  3. Tunn R, Schaer G, Peschers U, Bader W, Gauruder A, Hanzal E, et al: Update Recommendations on ultrasonography in urogynecology. Int Urogynecol J Pelvic Floor Dysfunct. 2005; 16(3):236-41
  4. Whittaker JL, Thompson JA, Teyhen DS, Hodges P. Rehabilitative ultrasound imaging of pelvic floor muscle function. J Orthop Sports Phys Ther. 2007; 37(8):487-98
  5. Ghanei A .Diagnostic Value of Transabdominal Ultrasonography in Determining the Pelvic Relaxation.Journal of Isfahan Medical School .2011; 28(122):1752-8. [In Persian]
  6. Ikai M, Fukunaga T. Calculation of muscle strength per unit cross-sectional area of human muscle by means of ultrasonic measurement. Int Z Angew Physiol. 1968; 26(1):26-32
  7. 7.Whittaker JL, Teyhen DS, Elliot JM, Cook K, Langevin HM, Dhal HH, Stokes M. Rehabilitative ultrasound imaging: understanding the technology and its applications. J Orthop Sports Phys Ther. 2007;37 (8):43449
  8. Teyhen DS, Gill NW, Whittaker JL, Henry SH, Hides JA, Hodges PW, Rehabilitative Ultrasound Imaging of the Abdominal Muscles. J Orthop Sports Phys Ther.2007; 37(8):450-466
  9. Segal RL.Use of Imaging to Assess Normal and Adaptive Muscle Function. Physical Therapy .2007; 87 (6):704-718.
  10. Dehghan Manshadi F, Parnianpour M, Sarrafzadeh J, Azghani M, Kazemnejad A. Abdominal hollowing and lateral abdominal wall muscles’ activity in both healthy men & women: An ultrasonic assessment in supine and standing positions. J Bodyw Mov Ther. 2011; 15(1):108-13
  11. White RD, McQuown D, McCarthy TA, Ostergard DR. Real-time ultrasonography in the evaluation of urinary stress incontinence. Am J Obstet Gynecol. 1980; 138(2):235-7.
  12. Galea MP, Tisseverasinghe S, Sherburn M. A randomised controlled trial of transabdominal ultrasound biofeedback for pelvic floor muscle training in older women with urinary incontinence. AUST NZ Cont J. 2013; 19(2): 38-44.
  13. Shurburn M, Murphy CA, Carroll S, Allen TJ, Galea MP. Investigation of transabdominal real-time ultrasound to visualize the muscles of the pelvic floor. Aust J Physiother. 2005; 51:167-170.
  14. Kelly M, Tan B-K, Thompson J, Carroll S, Follington M, Arndt A and Seet M. Healthy adults can more easily elevate the pelvic floor in standing than in crook lying: an experimental study. Aust J Physiother. 2007; 53(3):187-91.
  15. Thompson J, O’sullivan P. Levator plate movement during voluntary pelvic floor muscle contraction in subjects with incontinence and prolapse: a cross-sectional study and review. Int Urogynecol J Pelvic Floor Dysfunct. 2003; 14(2):84-8
  16. Dehghan Manshadi F, Sarrafzadeh J Parnianpour M. Kazemnejad A,  Ghanbari Z.  An Ultrasonic Investigation of Stability of Pelvic Floor in Women with and without Urinary Stress Incontinence. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2012; 15(13):16-25.[In Persian]
  17. Schaer GN, Koechli OR, Schuessler B, Haller U. Improvement of perineal sonographic bladder neck imaging with ultrasound contrast medium. Obstet Gynecol. 1995;86(6):950-4
  18. Schaer GN, Perucchini D, Munz E Peschers U, Koechli OR, De Lancey JO Sonographic evaluation of the bladder neck in continent and stress-incontinent women. Obstet Gynecol. 1999; 93(3):412-6
  19. Dehghan Manshadi F,  Parnianpour M. , Sarrafzadeh J  Ghanbari Z  , Azghani M .Standing Pelvic Postures and Continence Ultrasonic Parameters in Women with and without Stress Urinary Incontinence . Journal of Research in Rehabilitation Sciences 2013; under press. [In Persian]
  20. DalpiazO, Curti P. Role of perineal ultrasound in the evaluation of urinary stress incontinence and pelvic organ prolapse: A systematic review.  Neurourology and Urodynamics.2006; 25(4):301-306.
  21. Dietz HP, Lanzarone V. Levator trauma after vaginal delivery. Obstet Gynecol. 2005; 106(4):707-12.
  22. Dietz H.P, Eldridge A, Grace, M and Clarke B. Pelvic organ descent in young nulligravid women. Am J Obstet Gynecol. 2004; 191(1):95-9
  23. Yang Jenn‐Ming, Shwu‐Huey Yang, Wen‐Chen Huang, and Chii‐Ruey Tzeng. Factors affecting reflex pelvic floor muscle contraction patterns in women with pelvic floor disorders. Ultrasound Obstet Gynecol. 2013; 42(2):224-9
  24. Shek TC, Dietz HP. New imaging method for assessing pelvic floor biomechanics. Ultrasound Obstet Gynecol 2008; 31: 201–205
  25. Peng Q., Jones R., Shishido K., and Constantinou CE. Ultrasound Evaluation of Dynamic Responses of Female Pelvic Floor Muscles. Ultrasound Med Biol. 2007; 33(3): 342–352
  26. Bo K, Sherburn M. Evaluation of Female Pelvic- Floor Muscle Function and Strength. Phys Ther. 2005; 85(3):269-82.
  27. Thompson JA, O'Sullivan PB, Briffa NK, Neumann P. Comparison of transperineal and t ransabdominal ultrasound in the assessment of voluntary pelvic floor muscle contractions and functional maneuvers in continent and incontinent women. Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18(7):779-98.
  28. Bernstein IT. The pelvic floor muscles: muscle thickness in healthy and urinary-incontinent women measured by perineal ultrasonography with reference to the effect of pelvic floor training. Estrogen receptor studies. Neurourol Urodyn. 1997; 16(4):237-75.
  29. Mørkved S, Salvesen KA, Bø K, Eik-Nes S. Pelvic floor muscle strength and thickness in continent and incontinent nulliparous pregnant women. : Int Urogynecol J Pelvic Floor Dysfunct. 2004; 15(6):384-9.
  30. Majida M, Braekken IH, Bø K, Benth JS, Engh ME. Validation of three-dimensional perineal ultrasound and magnetic resonance imaging measurements of the pubovisceral muscle at rest. Ultrasound Obstet Gynecol. 2010; 35(6):715-22.

 

Volume 2, Issue 1 - Serial Number 1
March and April 2013
Pages 58-66
  • Receive Date: 02 August 2011
  • Revise Date: 22 January 2012
  • Accept Date: 11 July 2012
  • First Publish Date: 21 March 2013